A woman’s ovaries contain a store of eggs and produce various hormones, including estrogen. The monthly menstrual cycle (periods) depends on these hormones. At birth, a girl’s body contains about 1 million eggs, but as they grow older, their number decreases. The fewer eggs there are in the body, the more difficult it is to get pregnant. In most women living in the United States, by the age of 51, their egg supply is depleted so that the ovaries stop producing estrogen. When this happens, your period stops and menopause begins.
Due to the disappearance of estrogen and the onset of menopause, a number of changes can occur in the body, including:
- symptoms such as hot flashes, night sweats, sleep disturbances, and mood swings;
- changes in the vulva (outside of the vagina) and vagina;
- an increased risk of osteopenia or osteoporosis (loss of bone density or thinning), which can lead to an increased risk of fractures;
- increased risk of heart disease.
Menopause and cancer
Some cancer treatments can cause menopause at an early age in women. This is called premature menopause, early menopause, premature ovarian failure, or ovarian failure.
Causes of early menopause in women with cancer include:
- surgical removal of both ovaries;
- loss of eggs in the ovaries due to certain chemotherapy medications;
- loss of eggs in the ovaries due to exposure to radiation.
Although many women who have received cancer treatment do not experience early menopause, some women may experience it earlier than usual. This usually happens during or immediately after cancer treatment. However, for some women, menopause occurs years after cancer treatment. It is difficult to predict when a woman will have menopause and whether she will come earlier than usual due to cancer treatment.
If you are under 40, call your doctor or nurse if you have symptoms of early menopause, including:
- Irregular periods for 3 months or longer
- absence of periods for 3 months or longer;
- any symptoms of menopause.
Symptoms of menopause while taking certain medications
Some women receive medications (such as leuprolide) to suppress ovarian function. Menopause symptoms can also appear while taking these medications. If you have not received any other treatment that can lead to early menopause, your ovaries should start working again after you stop taking these drugs.
Treating menopausal symptoms
Hormone therapy for early menopause
In the event of early menopause, your doctor may recommend hormone therapy to replace hormones that are no longer being produced by your body in the right amount. Thanks to this, you can prevent some of the effects of early menopause on the body.
Hormone therapy can help by:
- treating menopausal symptoms;
- prevent bone thinning.
If you have a preserved uterus, your doctor will prescribe estrogen and progestin for you. If you have had a hysterectomy (surgery to remove the uterus), your doctor may only prescribe estrogen for you. Hormone therapy can be obtained in several different ways. Your doctor will tell you which method is best for you.
Some women are concerned about taking estrogen because of the health risks, but many of these risks are seen in women who take estrogen later in life after menopause naturally. There is no evidence that younger women who take hormone replacement medications that should be naturally produced at their age face the same risks.
Not all women can safely receive hormone therapy. In general, hormone therapy is not recommended for women with:
- hormone-sensitive tumors (eg, breast cancer);
- a history of blood clots;
- heart or vascular disease (with a history of heart attacks, high blood pressure, or strokes);
- liver disease;
- vaginal bleeding of unknown origin.
Talk to your doctor to see if it is safe for you to receive hormone therapy. If you can’t get hormone therapy, there are other ways to deal with the effects of menopause and early menopause. Some of these are described in the next section.
Ways to manage symptoms without hormones
You can also manage hormone-free symptoms by following the guidelines in this section.
Hot flashes and night sweats
Hot flashes usually begin with a warm sensation that occurs in the face, neck, chest and back and can spread throughout the body. The sensations of hot flashes can range from mild warmth and redness (blush) to pouring sweat. Some have hot flashes 1 or 2 times a day, while others more often, up to 3 times an hour. Hot flashes can come on suddenly during the day or wake you up at night.
Hot flashes can be minimized by avoiding smoking, caffeine, alcohol, and spicy foods. .
A good night’s sleep can make you feel better and energized. Some women with menopause or early menopause may have trouble sleeping – they may have difficulty falling asleep or waking up in the middle of the night.
Some women report changes in their mood after menopause. If you have been experiencing anxiety or depression for a long time, ask your doctor.
Changes in the vulva and vagina
After menopause, the vulva and vagina become drier and less elastic. Women who cannot receive hormone therapy can cope with these problems by regularly using moisturizers for the vulva and vagina, and by using vaginal lubricants during sexual activity. Some women may also use vaginal estrogen. For more information on using these products to control changes in the vulva and vagina, and to improve your sexual experience, see the resource Improving Vulvo vaginal Health.
Bone tissue condition
Osteopenia is a condition in which bone mineral density is below normal. Osteopenia can lead to osteoporosis, a disease in which bones become more fragile and brittle. The risk of developing these conditions increases due to the cessation of estrogen production, which is a consequence of menopause or early menopause.
There are a number of things you can do to reduce the chance of osteopenia turning into osteoporosis and to reduce the risk of fractures, including exercising and eating foods high in calcium and vitamin D. For more information on maintaining bone health, see the resource Osteoporosis Prevention.
Your doctor may recommend that you take calcium supplements, vitamin D supplements, or both if your diet is low in these elements. For information on the types of calcium supplements and how to take them, read our resource Calcium Supplements .
Stopping the production of estrogen during menopause or early menopause can affect your heart health. There are many ways you can reduce your risk of developing heart disease.
- Do not smoke.
- Eat heart-healthy foods and maintain a healthy weight.
- Exercise regularly. A good option is to do any exercise that increases your heart rate for 30 minutes, 5 days a week.
- If you have high blood pressure, diabetes, or high cholesterol, ask your doctor how to treat these conditions.